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Iodine status and thyroid function among lactating women in Saharawi refugee camps, Algeria
Get PDFMaster i samfunnsernæringBACKGROUND: Insufficient iodine intake as well as excess iodine intake may cause thyroid diseases. Endemic goitre and high urinary iodine concentration (UIC), probably caused by excess iodine, has been reported among Saharawi refugees. To what extent long-term excess iodine intake have influenced the thyroid function of the refugees is unknown.
OBJECTIVE: The main objective was to assess iodine status and thyroid function among lactating women in the Saharawi refugee camps.
METHOD: A baseline for a cohort study was performed among 111 lactating Saharawi women (18-50 years) living in the Algerian desert. Samples of casual urine, breast milk, public drinking water, goat - and camel milk were collected for determination of iodine concentrations. Dietary iodine intake through intake of water and milk was registered using 24-h recall. Thyroid function was assessed through serum levels of thyroid stimulating hormone (TSH), thyroglobulin (Tg), tyroxin (T4), thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb). In selected samples triiodothyronine (T3) and thyrotropin receptor antibody (TRAb) were determined.
RESULTS: Median UIC was 350 µg/L. The breast milk iodine concentration (BMIC) showed a median concentration of 479 µg/L. Median iodine concentrations in public drinking water, goat - and camel milk was 102, 952 and 2020 µg/L, respectively. The median dietary intake of iodine among the women was 407 µg/day. Thyroid function abnormalities were found in 23.4 % of the women: 12.6 % had subclinical hypothyroidism, 5.4 % autoimmune thyroiditis, 5.4 % subclinical hyperthyroidism, 3.6 % clinical hypothyroidism and 0.9 % clinical hyperthyroidism. Further, 17.1 % of the women had elevated serum Tg levels and positive TgAb was detected in 14.4 %. The age distribution was higher among women with thyroid abnormalities (p = 0.01). Dietary iodine intake correlated well with UIC (rs = 0.24, p = 0.01) and BMIC (rs = 0.47, p < 0.001). The prevalence of thyroid function abnormalities increased with higher UIC, although no significant correlation between UIC and TSH or UIC and Tg was found.
CONCLUSION: The lactating women had high levels of iodine in urine and breast milk, probably caused by excessive dietary iodine intake with public drinking water as a major contributor and animal milk presumably increasing the iodine intake when consumed. The high prevalence of thyroid abnormalities indicates that the long-term excess iodine intake might have influenced the thyroid function negatively
Mattilbud for rusmiddelavhengige. En kartlegging og vurdering av mattilbudet ved institusjoner tilknyttet Rusmiddeletaten i Oslo
No full textBakgrunn og mål: For om lag ti år siden ble det for første gang satt fokus på rusmiddelavhengiges svært mangelfulle kosthold. I 2011 ble det startet et prosjekt i regi av Oslo kommune, med mål om å bedre ernæringsstatus og tannhelse for beboere og brukere av Rusmiddeletatens institusjoner, kalt Prosjekt ERT. Masterstudien var knyttet til dette prosjektet. Hovedmålet med denne masterstudien var å kartlegge og vurdere mattilbudet ved institusjoner i Rusmiddeletaten. Utvalg og metode: Utvalget var 25 ulike institusjoner ved som var tilknyttet Prosjekt ERT. Studien baserte seg hovedsakelig på kvantitativ metode som forskningsstrategi, men med innslag av kvalitativ metode. Et selvutviklet spørreskjema, inkludert et måltidsintervju, var hovedinstrumentet for datainnsamlingen. Ernæringsansvarlig på hver enkelt institusjon, eventuelt annen ansatt, ble intervjuet. Resultater: Innholdsmessig ble de fleste enkeltmåltider ved institusjonene vurdert til å ha relativ stor variasjon av matvaregrupper eller til å være tilfredsstillende i forhold til kostråd, selv om økt bruk av frukt ville ha gjort mattilbudet mer fullverdig. Når det gjaldt tilbudet av spesifikke matvarer, ble det på flere institusjoner funnet noen svakheter, blant annet for mye bruk av fete, fine og sukkerholdige matvarer, samt rent sukker. Noen institusjoner hadde en lav måltidsfrekvens, og flere institusjoner manglet retningslinjer i forhold til mattilbudet. Når det gjaldt måltidssituasjonen, virket det som om samtlige institusjoner hadde fokus på å skape en hyggelig måltidsatmosfære. Konklusjon: Institusjonenes beboer- og brukergrupper varierer veldig, til og med innenfor en og samme seksjon. Det kan derfor være vanskelig å lage generelle retningslinjer som passer for alle institusjonene. Hver institusjon bør således vurderes enkeltvis slik at man kan sette sammen et fullverdig mattilbud som er tilpasset beboer- og brukergruppens ernæringsmessige beho
Kostholdsstudie blant Saharawiske kvinner i flyktningleirer ved Tindouf, Algerie: En kartlegging av matinntak og måltidsmønster blant flyktninger fra Vest-Sahara
Get PDFMaster i samfunnsernæringBackground: The high prevalence of goiter that studies have found among the refugees from Western Sahara living in refugee camps at Tindouf in Algeria, made the Ministry of Health in the exile government Polisario, make a request to conduct a study to examine and find solutions to this public health problem.
Objective: This cross-sectional study was conducted to determine food intake and meal patterns among women aged 15 to 45 in the refugee camps.
Methods. The sample consisted of 405 women of childbearing age, living in four refugee camps close to Tindouf in Algeria. Food intake was analyzed by the use of Individual Dietary Diversity Score (IDDS). 24-hour dietary interview was done to describe the meal pattern. Differences between the camps were also assessed. Background data at household level and on the women were obtained and anthropometric measurements were made.
Results: It was found that 98% of the women had eaten cereals such as bread, rice and spaghetti. Sixty percent had consumed milk products. Over half had eaten from vitamin A-rich vegetables and fruit, like carrots, and legumes, like lentils and beans. Ninety-four percent ate other vegetables like onions and potatoes. Almost 60 % had eaten meat, while less than half had eaten fish. Virtually all had consumed tea, oil and grease.
Forty-seven percent of women had low IDDS and ate from only two food groups, respectively, cereals and other vegetables. It was 28% of the women who had medium IDDS, they ate from three food groups, cereals, other vegetables, and enriched foods. Twenty-five percent of women had high IDDS, they had eaten from 7 different food groups. Respectively: cereals, dairy products, vitamin A rich vegetables and fruits, other vegetables, other fruits, legumes and fortified foods.
Virtually all the women had eaten breakfast, lunch and dinner, while only 38% had eaten between meals. Most ate breakfast at between 8 and 9 and it was mostly eaten bread and drunken tea for this meal. The lunch meal was most commonly eaten between 13 and 14. Women in Smara have eaten significantly more vegetables and fewer legumes than in the other camps. Evening meal was eaten by the majority at 22pm. Two thirds had consumed cereals such as rice or spaghetti for dinner, while in Dakla 83 % of the women had eaten cereals. In Dakla there were also many who had eaten fish. Approximately one quarter of the women ate one between meal, while only twelve women had eaten two in between meals. Between meals consisted mainly of tea, but also some milk. There were significantly more people drinking tea in Smara and milk in Dakla. The reasons for the differences between the camps may be because the camps receive food rations distributed in different weeks during a month.
Conclusion: Women in refugee camps in Tindouf, Algeria is characterized by the double burden of disease. They have deficiency diseases like anemia, goiter and diabetes, while many are suffering from obesity. The women in the camps were eating staple foods in the form of wheat, rice and spaghetti. In addition, legumes were also used as basic food, even if it is a typical protein source and should be a secondary food. Secondary Foods such as oil and fat was distributed along as basic food, while vegetables were distributed irregularly and in small quantities. People had to get their own milk. Peripheral foods that were eaten in the camps was tea and sugar. The food was eaten in three meals per day, respectively, breakfast, lunch and dinner, where lunch was the main meal. It was also tea- and milk drinking in between meals during the day. Significant differences between the camps according to what was eaten in the various meals were found. The reason these differences may be uneven distribution of food rations at camp leve
Kostholdsstudie blant Saharawiske kvinner i flyktningleirer ved Tindouf, Algerie: En kartlegging av matinntak og måltidsmønster blant flyktninger fra Vest-Sahara
No full textBackground: The high prevalence of goiter that studies have found among the refugees from Western Sahara living in refugee camps at Tindouf in Algeria, made the Ministry of Health in the exile government Polisario, make a request to conduct a study to examine and find solutions to this public health problem.
Objective: This cross-sectional study was conducted to determine food intake and meal patterns among women aged 15 to 45 in the refugee camps.
Methods. The sample consisted of 405 women of childbearing age, living in four refugee camps close to Tindouf in Algeria. Food intake was analyzed by the use of Individual Dietary Diversity Score (IDDS). 24-hour dietary interview was done to describe the meal pattern. Differences between the camps were also assessed. Background data at household level and on the women were obtained and anthropometric measurements were made.
Results: It was found that 98% of the women had eaten cereals such as bread, rice and spaghetti. Sixty percent had consumed milk products. Over half had eaten from vitamin A-rich vegetables and fruit, like carrots, and legumes, like lentils and beans. Ninety-four percent ate other vegetables like onions and potatoes. Almost 60 % had eaten meat, while less than half had eaten fish. Virtually all had consumed tea, oil and grease.
Forty-seven percent of women had low IDDS and ate from only two food groups, respectively, cereals and other vegetables. It was 28% of the women who had medium IDDS, they ate from three food groups, cereals, other vegetables, and enriched foods. Twenty-five percent of women had high IDDS, they had eaten from 7 different food groups. Respectively: cereals, dairy products, vitamin A rich vegetables and fruits, other vegetables, other fruits, legumes and fortified foods.
Virtually all the women had eaten breakfast, lunch and dinner, while only 38% had eaten between meals. Most ate breakfast at between 8 and 9 and it was mostly eaten bread and drunken tea for this meal. The lunch meal was most commonly eaten between 13 and 14. Women in Smara have eaten significantly more vegetables and fewer legumes than in the other camps. Evening meal was eaten by the majority at 22pm. Two thirds had consumed cereals such as rice or spaghetti for dinner, while in Dakla 83 % of the women had eaten cereals. In Dakla there were also many who had eaten fish. Approximately one quarter of the women ate one between meal, while only twelve women had eaten two in between meals. Between meals consisted mainly of tea, but also some milk. There were significantly more people drinking tea in Smara and milk in Dakla. The reasons for the differences between the camps may be because the camps receive food rations distributed in different weeks during a month.
Conclusion: Women in refugee camps in Tindouf, Algeria is characterized by the double burden of disease. They have deficiency diseases like anemia, goiter and diabetes, while many are suffering from obesity. The women in the camps were eating staple foods in the form of wheat, rice and spaghetti. In addition, legumes were also used as basic food, even if it is a typical protein source and should be a secondary food. Secondary Foods such as oil and fat was distributed along as basic food, while vegetables were distributed irregularly and in small quantities. People had to get their own milk. Peripheral foods that were eaten in the camps was tea and sugar. The food was eaten in three meals per day, respectively, breakfast, lunch and dinner, where lunch was the main meal. It was also tea- and milk drinking in between meals during the day. Significant differences between the camps according to what was eaten in the various meals were found. The reason these differences may be uneven distribution of food rations at camp leve
Challenges with iron deficiency anemia among women of reproductive age in Saharawi refugee camps, Tindouf Algeria
No full textThis study was carried out to assess the prevalence of iron deficiency anemia (IDA),
and identify the possible causes of the problem from the public health and nutrition
point of view. The target group used is women of reproductive age (15-49 years), both non-pregnant and pregnant women in the Saharawi refugee camps, in Tindouf,
Algeri
Iodine status and thyroid function among lactating women in Saharawi refugee camps, Algeria
No full textBACKGROUND: Insufficient iodine intake as well as excess iodine intake may cause thyroid diseases. Endemic goitre and high urinary iodine concentration (UIC), probably caused by excess iodine, has been reported among Saharawi refugees. To what extent long-term excess iodine intake have influenced the thyroid function of the refugees is unknown.
OBJECTIVE: The main objective was to assess iodine status and thyroid function among lactating women in the Saharawi refugee camps.
METHOD: A baseline for a cohort study was performed among 111 lactating Saharawi women (18-50 years) living in the Algerian desert. Samples of casual urine, breast milk, public drinking water, goat - and camel milk were collected for determination of iodine concentrations. Dietary iodine intake through intake of water and milk was registered using 24-h recall. Thyroid function was assessed through serum levels of thyroid stimulating hormone (TSH), thyroglobulin (Tg), tyroxin (T4), thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb). In selected samples triiodothyronine (T3) and thyrotropin receptor antibody (TRAb) were determined.
RESULTS: Median UIC was 350 µg/L. The breast milk iodine concentration (BMIC) showed a median concentration of 479 µg/L. Median iodine concentrations in public drinking water, goat - and camel milk was 102, 952 and 2020 µg/L, respectively. The median dietary intake of iodine among the women was 407 µg/day. Thyroid function abnormalities were found in 23.4 % of the women: 12.6 % had subclinical hypothyroidism, 5.4 % autoimmune thyroiditis, 5.4 % subclinical hyperthyroidism, 3.6 % clinical hypothyroidism and 0.9 % clinical hyperthyroidism. Further, 17.1 % of the women had elevated serum Tg levels and positive TgAb was detected in 14.4 %. The age distribution was higher among women with thyroid abnormalities (p = 0.01). Dietary iodine intake correlated well with UIC (rs = 0.24, p = 0.01) and BMIC (rs = 0.47, p < 0.001). The prevalence of thyroid function abnormalities increased with higher UIC, although no significant correlation between UIC and TSH or UIC and Tg was found.
CONCLUSION: The lactating women had high levels of iodine in urine and breast milk, probably caused by excessive dietary iodine intake with public drinking water as a major contributor and animal milk presumably increasing the iodine intake when consumed. The high prevalence of thyroid abnormalities indicates that the long-term excess iodine intake might have influenced the thyroid function negatively
Challenges with iron deficiency anemia among women of reproductive age in Saharawi refugee camps, Tindouf Algeria
Get PDFMaster i samfunnsernæringThis study was carried out to assess the prevalence of iron deficiency anemia (IDA),
and identify the possible causes of the problem from the public health and nutrition
point of view. The target group used is women of reproductive age (15-49 years), both non-pregnant and pregnant women in the Saharawi refugee camps, in Tindouf,
Algeri
Investigating health and nutrition messages given to pregnant women at Bwaila hospital in Lilongwe
No full textOBJECTIVE: This study was designed to investigate if health and nutrition messages given to pregnant women at Bwaila hospital in Lilongwe, Malawi were understood and used and if the messages made the women health and nutrition literate.
STUDY DESIGN: A cross sectional study where data was collected using two structured questionnaires. Purposive sampling was used to recruit the study participants and these were 60 first time pregnant women (Primigravida) who were in their third trimester and 10 nurses who attend to these women during antenatal sessions. Data on demographics, obstetric situation, antenatal services accessed, nutrition knowledge and practices and information provided and used, were collected from the pregnant women. Non parametric statistical analyses performed on data included Chi square (χ2), Kruskal-Wallis (H), Mann-Whitney (U) and Spearman's rho (�).
RESULTS: The findings show that distance to the hospital was a significant factor on when to make the first antenatal visit (p=0.014). Age was related with the number of routine visits (p=0.002), knowledge of the six food groups (p=0.025), knowing dietary sources of iodine (p=0.03) and correlated with making lifestyle changes (p<0.009). Education influenced the pregnant women’s perception of adequacy of time with the nurses during antenatal visits (p=0.002), and it was correlated with searching for other health information (p<0.03). The nurses/midwives faced a number of challenges in their work and were aware of the government policy. The nurses were aware that they had influence on the quality of service that they proved and they suggested training more nurses, giving health talks as ways to lower maternal mortality and that government should build more health facilities.
CONCLUSION
The pregnant women in this study had limited health and nutrition knowledge either due to the limited content of the information that the nurses provided or due to their own limited health and nutrition literacy skill
Investigating health and nutrition messages given to pregnant women at Bwaila hospital in Lilongwe
Get PDFMaster i samfunnsernæringOBJECTIVE: This study was designed to investigate if health and nutrition messages given to pregnant women at Bwaila hospital in Lilongwe, Malawi were understood and used and if the messages made the women health and nutrition literate.
STUDY DESIGN: A cross sectional study where data was collected using two structured questionnaires. Purposive sampling was used to recruit the study participants and these were 60 first time pregnant women (Primigravida) who were in their third trimester and 10 nurses who attend to these women during antenatal sessions. Data on demographics, obstetric situation, antenatal services accessed, nutrition knowledge and practices and information provided and used, were collected from the pregnant women. Non parametric statistical analyses performed on data included Chi square (χ2), Kruskal-Wallis (H), Mann-Whitney (U) and Spearman's rho (�).
RESULTS: The findings show that distance to the hospital was a significant factor on when to make the first antenatal visit (p=0.014). Age was related with the number of routine visits (p=0.002), knowledge of the six food groups (p=0.025), knowing dietary sources of iodine (p=0.03) and correlated with making lifestyle changes (p<0.009). Education influenced the pregnant women’s perception of adequacy of time with the nurses during antenatal visits (p=0.002), and it was correlated with searching for other health information (p<0.03). The nurses/midwives faced a number of challenges in their work and were aware of the government policy. The nurses were aware that they had influence on the quality of service that they proved and they suggested training more nurses, giving health talks as ways to lower maternal mortality and that government should build more health facilities.
CONCLUSION
The pregnant women in this study had limited health and nutrition knowledge either due to the limited content of the information that the nurses provided or due to their own limited health and nutrition literacy skill
Iodine intake and iodine status among lactating women and their children in the Saharawi refugee camps, Algeria
No full textBackground: People in the long-term refugee camps in the Algerian desert are exposed to high iodine intakes from water and animal milk. At the same time the goitre rate is very high, with a goitre prevalence of 18 % for the women and 11 % for school age children.
Objectives: The main objective for this thesis was to examine iodine intake among lactating women, their iodine excretion in urine, and if high iodine intake for the women will give high level of iodine in breast-milk. And further how feeding practises and breast milk iodine concentrations is affecting the children’s iodine concentration in urine. Methods: 110 lactating women with their 110 children from 0 up to 7 months of age were included. The women’s iodine intake was assessed by interviewed information of the last 24-hours and 7 days intake of iodine rich foods. To assess the iodine intake, samples of public water (n=24), camel milk (n=34) and goat milk (n=13) were collected from the women, as well as spot-urine and breast milk samples. Spot-urine was collected from the children as well as data on feeding practises. Iodine concentration in water and urine samples was determined by Sandell-Kolthoff reaction, whereas milk samples were determined by the Inductively Coupled Plasma-Mass Spectrometry method. Results: Median (p25-p75) iodine concentrations of camel milk, goat milk and drinking water were 2020 (1502-4137) µg/L, 952 (801-1787) µg/ L and 102 (80-255) µg/L, respectively. Estimated dietary iodine intake for the women was 409 (234-709) µg/day, where water seemed to be the main contributor to the iodine intake. The women had a median urinary iodine concentration (UIC) of 349 (207-526) µg/L, and UIC were positively associated with BMI and camel milk iodine intake which explained 9,3% of the variation in UIC. The median breast milk iodine concentration (BMIC) was 479 (330-702) µg/L, and was positively associated with water- and goat milk iodine intake and UIC, which explained 15,8% of the variation in BMIC. Even though only 6% of the children were exclusively breast fed, no other foods or drinks but breast milk showed any association with the children’s UIC. BMIC explained 9,9% of the variation in children’s UIC. The children had a median urinary iodine concentration of 728 (401-1145) µg/L. Conclusion: The median BMIC was generally higher than the median UIC and seemed to be affected more by dietary iodine intake than UIC. There are no upper levels of UIC or iodine intake for lactating women by the WHO. But 74 % of the women had iodine intakes above their daily recommended intake of 250 µg/day (WHO), indicating a high iodine exposure. The breast milk iodine concentrations were not favourable for children 0-7 months of age, which have a daily recommended intake of 90 µg/day (WHO). The children’s urinary iodine concentrations indicate that the iodine intake from breast milk is very high, with 89% of the children having a urinary iodine concentration ≥ 300 µg/L, which is the upper limit used for an adult population (WHO). It is likely that the high iodine exposure may cause thyroid disorders for the women and their childre
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